If you would like to make both a lump sum withdrawal and rollover your benefit, simply complete all four parts of the form.

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1 Fact sheet and form Withdrawal lump sum and/or rollover The Government has placed restrictions on when you can access your super, which generally must be preserved in the superannuation system in order to fund your retirement. What this fact sheet does This fact sheet explains how to make a lump sum withdrawal from your superannuation fund and/or roll over your benefit into another complying super fund. A form is attached to this fact sheet which will allow you to make a full or partial lump sum withdrawal and/or rollover request. The form is divided into four parts: Part A, Part B, Part C and Part D. If you would like to make both a lump sum withdrawal and rollover your benefit, simply complete all four parts of the form. If you want to make a part or full lump sum withdrawal complete Part A, B and D. If you want to roll over part or all of your benefit complete Part A, C and D. Who it is for? UniSuper members who want to make a lump sum withdrawal and/or roll over their benefit into a complying super fund. The Government has placed restrictions on when you can access your benefit. Generally, your super must remain in the superannuation system until you permanently retire from the workforce on or after reaching your preservation age (see table below to find your preservation age). Your preservation age varies depending on when you were born, as shown below: Your date of birth Preservation age Before 1 July July June July June July June July June July 1964 or after 60 When can you make a withdrawal? You can withdraw all or part of your preserved benefits at any time as a lump sum (cash) if: you permanently retire from the workforce on or after reaching your preservation age you reach age 60 and an arrangement under which you were employed ceases There are three possible classifications when it comes to your super preserved, restricted non-preserved, and unrestricted non-preserved. Part or all of your restricted non-preserved benefits can be accessed when you terminate employment with a UniSuper employer* who had contributed to UniSuper on your behalf. Part or all of your unrestricted non-preserved benefits can be accessed at any time, regardless of your age, employment situation or financial position, and are generally made up of benefits that you ve already become entitled to, but voluntarily decided to keep within the super system (for example perhaps you ve already reached age 65 but you re still working). Please note, if you leave your job and UniSuper is not the default super fund at your new employer, you may nominate UniSuper as your chosen fund for your Superannuation Guarantee contributions (that is, the compulsory 9% employer contributions), providing your new employer offers choice of fund. Your new employer can then pay your super contributions into your existing UniSuper account. *A UniSuper employer is an employer that has entered into a participation agreement with the Trustee. you reach age 65, or your employment with a UniSuper employer* is terminated and your benefit is less that $200.

2 Each partial lump sum withdrawal or partial rollover will cost $37*. Please refer to your most recent Benefit Statement for information about the preservation components of your benefit and the relevant Product Disclosure Statement for more information about when you can withdraw your benefit. Alternatively, you can call the UniSuper Helpline on *Note that fees are generally increased in line with inflation at 1 July each year. Defined Benefit Division (DBD) members If you are a member of UniSuper s Defined Benefit Division (DBD) and elect to make a withdrawal from your defined benefit component, you will automatically cease to be a member of the DBD. Your remaining balance and all future employer and member contributions will be transferred to an Accumulation 1 account. Temporary resident members A temporary resident whose visa has expired or been cancelled is able to claim his or her super benefit from UniSuper as a lump sum once they have permanently departed Australia. If the benefit is not claimed within six months of departing Australia, the benefit becomes unclaimed money and UniSuper must pay it to the Australian Taxation Office (ATO). Providing your tax file number Under the Superannuation Industry (Supervision) Act 1993, UniSuper is authorised to collect your tax file number (TFN), which will only be used for lawful purposes. These purposes may change in the future as a result of legislative changes. You are not obligated to provide your TFN. However, if you do not provide your TFN, tax will be deducted from your withdrawal at the highest marginal tax rate plus the Medicare levy. Your TFN may be disclosed to another super fund when your benefits are being rolled over, unless you request in writing that your TFN is not to be disclosed to any other trustee. Tax on lump sum withdrawals If you are under age 60, tax will be automatically deducted from your lump sum withdrawal. If you do not provide your TFN, tax will be deducted from your withdrawal at the highest marginal tax rate plus the Medicare levy. Tax on rollovers No tax is payable on rollovers. Please call the UniSuper Helpline on for further information. When can you roll over your super? You can roll over all or part of your accumulation component/account to another super fund at any time. If you are currently employed by a UniSuper employer, please complete a Portability transfer form in order to make a rollover, available from the UniSuper website or by calling the Helpline on Partial withdrawal or rollovers? If you make a partial withdrawal or rollover, you must leave a minimum of $1,000 in your account. If the amount requested in a partial withdrawal or rollover does not allow a minimum account balance of $1,000 to be retained in UniSuper, the amount withdrawn or rolled over will be your account balance less $1,000. Page 2 of 4

3 Completing Proof of Identity UniSuper is required to verify your identity to prove that you are the person to whom the superannuation entitlements belong before providing any service to you. To ensure that the service can be provided promptly, please ensure that you provide all necessary certified proof of identity documents. Proof of identity documents that have not been correctly certified cannot be accepted. Please note, UniSuper does not require original proof of identity documents. Instead, we need to receive certified copies of the proof of identity documents. Acceptable documents Please provide certified copies of either: One of the following documents only: driver s licence issued under State or Territory law (or issued under foreign law if containing your photograph) Australian passport (or foreign passport if containing your photograph and signature) proof of age card issued under State or Territory law national ID card issued by a foreign government or the United Nations (if containing your photograph and signature). One of the following documents: Birth certificate or birth extract Citizenship certificate issued by the Commonwealth Pension card issued by Centrelink Health card issued by Centrelink. AND One of the following documents: letter from the Commonwealth, State or Territory in the past 12 months regarding a Government assistance payment notice of assessment from the Australian Taxation Office in the past 12 months notice from a local council or utilities provider in the past three months. For example:»»»» rates notice electricity bill. Certification of documents To obtain a certified copy of a proof of identity document, take the original document and a photocopy to a person who is authorised to certify documents (see below). The person must sight the original and the photocopy, make sure both documents are identical, then ensure that all photocopied pages of the ORIGINAL proof of identification documents (including any linking documents) are certified as true copies by writing or stamping certified true copy followed by their signature, printed name, qualification (eg Justice of the Peace, Australia Post employee) and date. Change of name or signing on behalf of another person OR If you have changed your name or are signing on behalf of the applicant you will need to provide a certified linking document that proves a relationship exists between two or more names. Purpose Change of Name Signing on behalf of another person Suitable linking document Marriage certificate Deed poll Change of name certificate from the Births, Deaths and Marriages Registration Office Power of attorney Guardianship papers Administration order Page 3 of 4

4 Persons who are authorised to certify proof of identity documents Occupations Chiropractor Dentist A legal practitioner, who is enrolled on the roll of the Supreme Court of a State or Territory, or the High Court of Australia Medical practitioner Nurse Optometrist Patent attorney Pharmacist Physiotherapist Psychologist Trade marks attorney Veterinary surgeon Other persons Agent of the Australian Postal Corporation who is in charge of an office supplying postal services to the public Australian Consular Officer or Australian Diplomatic Officer (within the meaning of the Consular Fees Act 1955) Bailiff Bank officer with 2 or more continuous years of service Building society officer with 2 or more years of continuous service Chief executive officer of a Commonwealth court Clerk of a court Commissioner for Affidavits Commissioner for Declarations Credit union officer with 2 or more years of continuous service Employee of the Australian Trade Commission who is: (a) in a country or place outside Australia; and (b) authorised under paragraph 3(d) of the Consular Fees Act 1955; and (c) exercising his or her function in that place. Employee of the Commonwealth who is: (a) in a country or place outside Australia; and (b) authorised under paragraph 3(c) of the Consular Fees Act 1955; and (c) exercising his or her function in that place. Fellow of the National Tax Accountants Association Finance company officer with 2 or more years of continuous service Holder of a statutory office not specified in another item in this section Judge of a court Justice of the Peace Magistrate Marriage celebrant registered under Subdivision C of Division 1 of Part IV of the Marriage Act 1961 Master of a court Member of Chartered Secretaries Australia Member of Engineers Australia, other than at the grade of student Member of the Association of Taxation and Management Accountants Member of the Australian Defence Force who is: (a) an officer; or (b) a non-commissioned officer within the meaning of the Defence Force Discipline Act 1982 with 2 or more years of continuous service; or (c) a warrant officer within the meaning of that Act. Member of the Institute of Chartered Accountants in Australia, the Australian Society of Certified Practising Accountants or the National Institute of Accountants Member of: (a) the Parliament of the Commonwealth; or (b) the Parliament of a State; or (c) a Territory legislature; or (d) a local government authority of a State or Territory. Minister of religion registered under Subdivision A of Division 1 of Part IV of the Marriage Act 1961 Notary public An officer with, or authorised representative of, a holder of an Australian financial services licence, having 2 or more years of continuous service with one or more licences Permanent employee of the Australian Postal Corporation with 2 or more years of continuous service who is employed in an office supplying postal services to the public Permanent employee of: (a) the Commonwealth or a Commonwealth authority; or (b) a State or Territory or a State or Territory authority; or (c) a local government authority; with 2 or more years of continuous service who is not specified in another item in this section Person before whom a statutory declaration may be made under the law of the State or Territory in which the declaration is made Police officer Registrar, or Deputy Registrar, of a court Senior Executive Service employee of: (a) the Commonwealth or a Commonwealth authority; or (b) a State or Territory or a State or Territory authority Sheriff Sheriff s officer Teacher employed on a full-time basis at a school or tertiary education institution Member of the Australasian Institute of Mining and Metallurgy Send your form back to UniSuper Post your completed and signed fact sheet and form to UniSuper, Level 37, 385 Bourke Street, Melbourne VIC Please note, faxed copies cannot be processed. Find out more enquiry@unisuper.com.au This information is general information only and is not intended to be advice. It has been prepared without taking account of your objectives, financial situation or needs. Before deciding to acquire or hold an interest in any UniSuper product, you should consider whether it is appropriate for you and consider the relevant product disclosure document, which is available from your employer or UniSuper. Issued by: UniSuper Limited. Level 37, 385 Bourke Street, Melbourne VIC Phone UniSuper: ABN Trustee: UniSuper Limited, ABN Date: July 2009 Copyright in this form is owned by UniSuper Limited Page 4 of 4

5 Withdrawal form Use this form to make a lump sum withdrawal and/or rollover super benefits to another complying super fund. Important information Lump sum withdrawal or rollover? This form is divided into four sections: Part A Your details Part B Lump sum withdrawal Part C Rollover to another complying super fund Part D Declaration If you would like to make both a lump sum withdrawal and rollover your benefit, complete all 4 parts of this form. PART A Your details SECTION 1 Member details Please use BLACK or BLUE BALL POINT PEN and print in CAPITAL LETTERS. Cross where required X Title: Mr Mrs Ms Dr Professor Other Surname Given name Withdrawal fee Each partial lump sum withdrawal will cost $37. Please note that UniSuper s fees are generally increased in line with inflation after 1 July each year. Proof of identity UniSuper is required by law to verify your identity before processing a withdrawal. Please attach certified copies of proof of identity documentation to this form. Details about which documents can be accepted can be found in the attached fact sheet. Further information If you need further information or help to complete this form: enquiry@unisuper.com.au call the UniSuper Helpline on , or visit our website at Date of birth (DD/MM/YYYY) / / Residential address, Number and Street (not PO Box) Suburb/Town State Postcode Country (if not Australia) Postal address, Number and Street (or PO Box if applicable) Privacy information UniSuper recognises the importance of protecting your personal information and is committed to complying with its privacy law obligations. To find out more about how UniSuper collects and manages your personal information, please refer to UniSuper s Privacy Policy, which is available from UniSuper s website at or by calling the UniSuper Helpline on between 9am and 5pm (AEST), Monday to Friday. Suburb/Town State Country (if not Australia) Postcode What is the phone number you wish UniSuper to call you on if there is a question we need to ask you regarding this form? Contact number (during business hours) ( ) UniSuper Member Number (If you are unsure of your member number, refer to your most recent Benefit Statement or call the UniSuper Helpline.) UniSuper: ABN Trustee: UniSuper Limited, ABN , Level 37, 385 Bourke Street, Melbourne VIC, 3000 Date: 1 July 2009 UNISF form continues ÊWITHDRAWALlŠ

6 PART A Your details continued SECTION 2 Tax File Number You do not have to provide your Tax File Number (TFN), however, if you do not provide your TFN, you may pay more tax than you need to on your withdrawal. SECTION 4 Your request Which type of withdrawal would you like to make? a lump sum withdrawal Go to PART B Your Tax File Number SECTION 3 Residency/Visa status What type of residency or visa do you have? Australian citizen, Permanent resident, New Zealand citizen or Retirement visa (405 or 410) Go to SECTION 4 rollover to another super fund both a lump sum withdrawal and a rollover to another super fund Go to PART C Complete PART B and PART C Temporary resident, (Refer to the attached fact sheet for information on how temporary residents can can access their benefit) You cannot use this form to withdraw this benefit. However, you can still use this form to roll out your super benefit to another complying super fund. Please call UniSuper on for further information. Page 2 of 2

7 PART B Lump sum withdrawal SECTION 5 Full or partial withdrawal Would you like to make a full or partial withdrawal? Full Partial If you are making a partial withdrawal, you must leave a minimum of $1,000 in your account. Tax will be automatically deducted if you are under age 60. How much do you wish to withdraw? $,,. Please indicate if this is the gross or net amount. (Select one box only) Gross Before tax is deducted SECTION 8 Your financial institution s details Please specify the financial institution account into which your withdrawal is to be paid Please attach the appropriately certified proof of identity documents. Details about which documents can be accepted, can be found in the Completing proof of identity section in the fact sheet accompanying this form. Financial institution name Postal address Number and Street (or PO Box if applicable) Net After tax is deducted Do you wish to make a partial rollover to another complying super fund? Yes No Suburb/Town State Postcode Name in which the account is held SECTION 6 Reason for withdrawal request Please select one of the following options. I am withdrawing my unrestricted non-preserved benefits I have terminated employment with a UniSuper employer and my preserved benefits are less than $200 BSB number Account number I have reached age 55 and have permanently retired from the workforce form continues I have reached age 60 and an arrangement under which I was gainfully employed has come to an end I am aged 65 or over SECTION 7 Payment options There are two types of payment options. Electronic Funds Transfer (EFT) or cheque. Which payment option would you like? EFT Go to SECTION 8 Cheque If you select cheque, the withdrawal payment will be forwarded to the address in Section 1. Go to SECTION 11 Page 3 of 4

8 PART C Rollover to a complying super fund SECTION 9 Full or partial rollover Would you like to rollover all or part of your UniSuper benefit to another complying super fund? Full rollover Go to SECTION 10 Partial rollover No Please note, if you make a partial rollover, you must leave a minimum of $1,000 in your account. If you are currently employed by a UniSuper employer, you will need to complete a Portability transfer form in order to make a rollover. How much do you wish to rollover? $ Go to Part D,,. SECTION 10 Rollover fund details Complete your rollover fund details below. Rollovers will be forwarded to your nominated super fund by cheque (EFT not available). Full name of fund Postal address. PART D Declaration SECTION 11 Declaration Please read this Declaration before you sign and date your form. I declare that I have read this form and the information I have provided on this form is true and correct I understand that I have the right to ask UniSuper for information about the effect the withdrawal or rollover may have on my benefit entitlements and do not require any further information I request and consent to the withdrawal or rollover of my benefit as indicated on this form and authorise UniSuper to give effect to the withdrawal or rollover I understand that: if I do not provide my TFN I may be liable to pay additional tax on my withdrawal (if applicable) a fee of $37 will apply to my withdrawal (if applicable) I understand that if I have not provided the appropriately certified proof of identity information my application cannot be processed I discharge UniSuper of all further liability in respect of the benefits rolled over to my nominated rollover fund (if applicable) I consent to my personal information being used in accordance with UniSuper s Privacy Policy. Signature 7 Date (DD/MM/YYYY) / / Suburb/Town State Postcode Membership/policy number ABN number (must complete) Please note: Faxed copies cannot be processed. Please include with this form certified copies of proof of identity documentation refer to the attached fact sheet for more information. Post your completed and signed fact sheet and form to: UniSuper Level 37, 385 Bourke Street Melbourne VIC 3000 SPIN (if known) For a rollover to self-managed super funds (SMSFs) please attach appropriately certified proof of identity documents. Details about which documents can be accepted, can be found in the Completing proof of identity section in the fact sheet accompanying this form. Copyright in this form is owned by UniSuper Limited Printed on Tudor RP 100% recycled paper Page 4 of 4

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